Provider Demographics
NPI:1912443029
Name:ALAN J VALLARINE DDS INC 2
Entity Type:Organization
Organization Name:ALAN J VALLARINE DDS INC 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:VALLARINE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:219-345-2486
Mailing Address - Street 1:2828 FRESNO ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1327
Mailing Address - Country:US
Mailing Address - Phone:559-263-9648
Mailing Address - Fax:
Practice Address - Street 1:2828 FRESNO ST
Practice Address - Street 2:SUITE 100
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1327
Practice Address - Country:US
Practice Address - Phone:559-263-9648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty